Losart-P
Generic Name
Losartan Potassium + Hydrochlorothiazide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| losart p 50 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Losart-P is a combination medicine containing Losartan Potassium, an Angiotensin II Receptor Blocker (ARB), and Hydrochlorothiazide, a thiazide diuretic. It is primarily used to treat high blood pressure (hypertension) and reduce the risk of cardiovascular events.
Uses & Indications
Dosage
Adults
Typical starting dose is Losartan 50 mg / Hydrochlorothiazide 12.5 mg once daily. Dose may be increased after 2-4 weeks to Losartan 100 mg / Hydrochlorothiazide 25 mg once daily if needed.
Elderly
No initial dosage adjustment is usually needed for elderly patients, but monitoring is recommended.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Dose adjustment needed for moderate impairment.
How to Take
Oral administration. Can be taken with or without food. It is recommended to take it at the same time each day, preferably in the morning due to the diuretic component.
Mechanism of Action
Losartan blocks the binding of angiotensin II to AT1 receptors, leading to vasodilation, reduced aldosterone secretion, and decreased blood pressure. Hydrochlorothiazide increases the excretion of sodium and chloride by inhibiting their reabsorption in the renal tubules, leading to fluid loss and decreased blood volume, thereby lowering blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect typically within 6 hours, maximal effect within 3-6 weeks for chronic use.
Excretion
Losartan and its metabolite are excreted via urine and feces. Hydrochlorothiazide is primarily excreted unchanged in the urine.
Half life
Losartan: 2 hours (active metabolite E-3174: 6-9 hours). Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Losartan is well absorbed orally, with a bioavailability of about 33%. Hydrochlorothiazide has an oral bioavailability of 65-75%.
Metabolism
Losartan undergoes significant first-pass metabolism to an active carboxylic acid metabolite (E-3174). Hydrochlorothiazide is not metabolized.
Side Effects
Contraindications
- Hypersensitivity to Losartan, hydrochlorothiazide, or sulfonamide-derived drugs
- Anuria (absence of urine production)
- Severe renal impairment
- Severe hepatic impairment
- Pregnancy (second and third trimesters)
- Concomitant use with aliskiren in diabetic patients
Drug Interactions
Lithium
Renal clearance of lithium may be reduced, increasing lithium toxicity.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension.
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment of antidiabetic drugs may be required due to hydrochlorothiazide's effect on blood glucose.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the diuretic and antihypertensive effects of the drug and increase the risk of renal impairment.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene), potassium supplements, or salt substitutes containing potassium
May lead to increased serum potassium levels (hyperkalemia).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include hypotension, tachycardia, bradycardia (less common), electrolyte imbalance (e.g., hypokalemia, hyponatremia). Treatment is symptomatic and supportive; hydration and correction of electrolyte imbalance are crucial.
Pregnancy & Lactation
Category D for Losartan in the 2nd and 3rd trimesters of pregnancy; Category C for the 1st trimester. Hydrochlorothiazide is Category B. Contraindicated in the 2nd and 3rd trimesters due to potential fetal harm. Avoid during lactation as both components are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to Losartan, hydrochlorothiazide, or sulfonamide-derived drugs
- Anuria (absence of urine production)
- Severe renal impairment
- Severe hepatic impairment
- Pregnancy (second and third trimesters)
- Concomitant use with aliskiren in diabetic patients
Drug Interactions
Lithium
Renal clearance of lithium may be reduced, increasing lithium toxicity.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension.
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment of antidiabetic drugs may be required due to hydrochlorothiazide's effect on blood glucose.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the diuretic and antihypertensive effects of the drug and increase the risk of renal impairment.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene), potassium supplements, or salt substitutes containing potassium
May lead to increased serum potassium levels (hyperkalemia).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include hypotension, tachycardia, bradycardia (less common), electrolyte imbalance (e.g., hypokalemia, hyponatremia). Treatment is symptomatic and supportive; hydration and correction of electrolyte imbalance are crucial.
Pregnancy & Lactation
Category D for Losartan in the 2nd and 3rd trimesters of pregnancy; Category C for the 1st trimester. Hydrochlorothiazide is Category B. Contraindicated in the 2nd and 3rd trimesters due to potential fetal harm. Avoid during lactation as both components are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Studies like the LIFE study demonstrated the cardiovascular benefits of Losartan in hypertension with LVH, including stroke risk reduction. Combinations with HCTZ have also been extensively studied for efficacy in blood pressure control.
Lab Monitoring
- Serum electrolytes (potassium, sodium)
- Renal function (creatinine, BUN)
- Liver function tests
- Uric acid levels (hydrochlorothiazide can increase uric acid)
Doctor Notes
- Advise patients on lifestyle modifications.
- Monitor serum electrolytes, renal function, and blood pressure regularly.
- Caution with patients prone to dehydration or electrolyte imbalance.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Report any unusual symptoms or side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Adopt a low-sodium diet.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol intake.
- Quit smoking.
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